Cutrina asked
I am currently on the generic medication for lexapro, esciltopram. I have been on 5mg once a day for about 6 months. I would like to come off of it. How best should I do this? I know I shouldn't go cold turkey but I only have seven pills left and can not get another refill. How long will the withdrawal symptoms last?
Answer
Withdrawal symptoms from antidepressants like Lexapro (Escitalopram) vary from person to person but they are usually mild, self-limiting and able to be greatly reduced by tapering off the medication slowly. If they do occur, they can last from a few days to a few weeks, depending on the person and specific situation.
Possible withdrawal symptoms are often noted by the acronym FINISH:
- Flu Like Symptom
- Insomnia
- Nausea
- Imbalance
- Sensory Disturbances
- Hyperarousal
There are no 'set in stone' guidelines for tapering antidepressant medications but there are general recommendations that many practitioners follow.
The American Psychiatric Association has published the "Practice Guideline For The Treatment Of Patients With Major Depressive Disorder"and it states "When pharmacotherapy is being discontinued, it is best to taper the medication over the course of at least several weeks".
The general rule of thumb that many practitioners follow is to start decreasing the medication dose by a low amount and go slow with the taper...taking account of any withdrawal symptoms the patient is experiencing. You will often see 25% dose reduction every 1-4 weeks but again it is highly dependent on how the patient is reacting to the change. You are on a very low dose of the drug, 5mg, and you would therefore most likely need to split the tablet into halves, fourths etc... to titrate down properly.
Be aware that tapering medications, no matter how fast, may not completely eliminate symptoms.
If symptoms do happen, they tend to be mild as mentioned above and can last anywhere from a few days to a few weeks. Of course, there is always the option of employing a slower tapering method if they do happen to lessen the severity.
I strongly recommend you and your doctor work together on a tapering strategy that you are both comfortable with. It is important that your doctor be able to monitor your progress.
